Abstract The prevalence of interstitial cystitis (IC) has seen different treatment methods that have been aimed at reducing the level of pain and ensuring that the patients are comfortable. However, the continued failure of most of the conventional methods to treat the condition has necessitated physicians to recommend complementary and alternative methods of managing the condition. An analysis of the complementary and alternative methods (CAM) modalities is therefore, critical in understanding the different conceptual attributes that are significant in addressing the problem. IC is a condition that is characterized by chronic pain or discomfort in the bladder and the surrounding pelvic region. It differs depending on the pain, frequency or both pain and frequency. The condition affects the patient and in some cases may lead to stress since it impacts the work-life, family and sexual enjoyment for the women. In most cases there are different methods of managing the condition but although they have been highly documented, physicians and patients are slowly appreciating the need for CAM to manage the conditions. It makes it critical to examine the different methods and their contribution especially in patients who have refractory and debilitating conditions in the society. This paper assesses the different recommended CAM modalities; their use and success rate among patients suffering from IC in the society. The paper uses a qualitative method of research where different methods were examined for their use and prevalence among physicians and patients across the society. The results showed that there has been an increase in the use of CAM methods in the treatment of interstitial cystitis which has seen a reduction in pain among most of the individuals in the society.

Introduction

When analyzing the CAM methods, it is important to highlight the level of prevalence of the condition in the society as it affects more than 3-8million Americans. However, most of the patients are women and although it may occur at any age, most cases are between 42 and 46 years of age. Women constitute more than 90% of the total cases highlighting the importance of highlighting the main management methods that do not include medication or conventional processes that can be used (Tutolo et al, 2016). The management practices need to be instituted in terms of the pain and frequency of the condition in an individual. The CAM methods have therefore shifted from a specific model to multifaceted methods that incorporate a series of models aimed at controlling the condition.

It is also imperative to ensure that an individual approach has been developed to ensure that the patient is treated depending on their specific complications. A one size fits all approach in CAM rarely applies since there are differences in the conditions and models that the patients face. It is essential to understand the patient’s dynamics and institute a program that aligns with their individual needs (Atchley et al, 2015). Attributes such as depression also make it critical to understand the different models that are instituted by patients in the models used to manage the condition. On the other hand, before a diagnosis of IC it is important to rule out conditions that manifest in similar signs such as an infection or urinary stones which may be affected by the CAM method that is used. There are a variety of CAM modalities that can be used to treat IC that include:

1. biologically-based therapies, including dietary modification, nutraceutical and herbal supplement usage;

2. mind-body interventions, like cognitive behavioral therapy, psychotherapy, yoga or biofeedback exercises;

3. manipulative and body-based approaches, i.e., massage techniques, bladder retraining and physical therapy;

4. energy therapies, like Qigong, Reiki and bioelectromagnetic-based therapy;

5. whole medical systems, i.e., traditional Chinese medicine, acupuncture and naturopathy (Moquin, Blackman, Mitty & Flores, 2009).

To understand how these CAM modalities are effective, however, it is important to understand what IC is.

IC has been defined as suprapubic pain stemming from a bladder filling all the way, while accompanied by a range of symptoms that can include a higher rate of day-time and night-time urination frequency (Pang & Ali, 2015, p. 653). IC cannot be diagnosed if a urinary tract infection is diagnosed or if some other pathology is identified. The major difficulty of treating IC, therefore, is that its etiology is poorly understood. There is no clear reason or explanation for the suprapubic pain associated with the bladder filling. Moreover, nearly 200 different therapies have been developed and implemented to treat IC, yet none of them is fully successful across the board for all patients (Rovner et al., 2000). For that reason CAM therapies are viewed by patients and physicians as an attractive option (O’Hare et al., 2013).

The literature shows that CAM treatments are on the rise among patients of IC and that many more physicians today are recommending CAM for IC patients than ever before (Pang & Ali, 2015). The primary reason for this is that IC etiology is so poorly understood that some physicians believe alternative methods may have a beneficial psychological impact on patients (Kaptchuck, 2002). This could be just a placebo effect—for example, a patient suffering from an issue that has no known origin and thus has no known effective treatment is given an intervention that is rooted more in traditional culture (such as Chinese medicine) than in modern science; the patient believes there is something special about the intervention (the mystery...

Hyodo et al. (2005) for example have found that patients receive an emotionally supportive stimulus from CAM methods of intervention for ailments that seem untreatable via other interventions. However, other researchers have put forward evidence indicating that there is more to CAM than a mere placebo effect and that in fact the methods do work effectively in treating IC patients (O’Hare et al., 2013; Pang & Ali, 2015). For that reason, this study will now describe the most common and most effective CAM treatments for IC patients and what the research on them has revealed over the years.
IC Diet

Dietary modification is one of the most common CAM that is applied by individuals across the society (O’Hare et al., 2013). As Hanno et al. (2011) have shown, the dietary modification approach is considered a first line approach in the CAM treatment of IC. Likewise, the American Urology Association has considered the dietary modification intervention as the main form of therapy (Colaco & Evans, 2015).

The dietary modification method is characterized by avoidance of foods that are known to cause irritation to the bladder. Avoidance of coffee, citrus and other acidic foods is highly recommended as these foods are likely to cause the pain that most of the patients have. However, it is critical to understand and look to ensure that one develops the best therapeutic methods essential in ensuring that there is proper modification methods instituted, as not everyone will respond in the same way to dietary modification (Atchley et al, 2015; O’Hare et al., 2013; Pang & Ali, 2015). The symptoms vary depending on the patients and the diets need to be tailored towards ensuring that the conditions that the patient faces are considered. This makes it imperative to use elimination diet to determine which foods are irritants for each patient.

The differences need to be specifically underlined through creating a proper scope and modeling essential for outlining the critical controls developed. Research has shown that most of the patients like the dietary method of management since it helps in reducing the effects of the condition (Koziol, Clark, Gittes & Tan, 1993). Proper dietary methods eliminates pain in most of the patients as they eliminate foods that are high in acidity and look to develop the best means towards developing proper models to reduce the effects in their bodies. Acidity is the main attribute that leads to problems in most patients and clinicians look to institute programs that are aimed at changing these attributes for patients.

Elimination of diet of bladder irritants, decreasing the dietary acid load and urinary alkalinity are some of the methods used in controlling the level of pain from IC. Patients are given baking soda or potassium citrate that acts as treatment options towards reducing the effect of the foods taken (Atchley et al, 2015). In cases where there are refractory symptoms it is important to ensure that the patient receives the proper care and models that are essential in instituting the best practices and models of change in the set systems. Voiding food diaries are also recommended to track the food intake and frequency of IC for patients (Pang & Ali, 2015). This helps in assessing the foods and the different symptoms that the patient suffers.

Critical examination is necessary to assess if the patient suffers from an increase or decreased pain from the recommended food proportions. However, alcoholic beverages, carbonated drinks, caffeine, spicy foods and vinegar are some of the foods that a patient needs to avoid at all times. It is critical to ensure that the proper systems have been adopted towards ensuring that the patient does not suffer from increased food intakes and poor dieting programs. The elimination of all sensitive foods and beverages should last for between 2 and 3 months with slight modifications made thereafter until the right diet for the patient is identified (Whitmore, 2002). The critical methods outlined need to meet the critical demands and models that are essentially indicated. Doctors need to closely monitor and advice their patients towards implementing the critical controls and models essential for change in their dietary program. These are essential towards accentuating and creating a proper control process that matches the significant changes and controls needed towards managing the condition.

Though the elimination diet works for the majority of patients (O’Hare et al., 2013) more research is however needed to assess the success of the method since most of the people do not commit to the model for many years or a long period of time. Although research indicates that there are improvements in the condition of the patients, there is a gap that exists in outlining the critical recommendations and models that are needed in developing the best approaches (Pang & Ali, 2015). Critical evidence is required towards outlining the best practices through an evidence-based approach that would outline the critical controls and constructs needed within the management program.

Cognitive Behavioral Therapy and Psychotherapy

Cognitive behavioral therapy (CBT) aims at developing coping strategies that are essential in helping the patients cope with the pain and overcome the growing challenges. This is mainly achieved through altering the pain beliefs and altering their psyche towards achieving better results. An adoption of interdisciplinary methods have been developed which essentially develop…